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Help!! Modifiers For Lab Codes (clia Waived Tests)

  1. Default Help!! Modifiers For Lab Codes (clia Waived Tests)
    Medical Coding Books
    I have been receiving rejections for lab codes from medicare. I have added QW to them however some still won't pay. What do I do?

  2. #2
    Check with support for your billing software... we had the same problem with medicaid on CLIA waived tests... it turns out someone had changed one space in the description on our software that stopped the our CLIA number from reporting on the claim the way it should. Hope this helps...
    Barbara Haskins CPC

  3. #3
    Is your CLIA number loaded into your software system? Check to make sure this number is printing on the claim or transmitting appropriately. I agree with the other response you received, make sure your modifier's are transmitting or printing correctly. One last thing, are your keeping up with the current list of labs that are CLIA waived?

  4. #4
    You may also want to check the list of CLIA waived tests to see if the code you are billing requires the QW modifier. Not all CLIA waived tests need the modifier.
    Amy Crego, CPC, CPC-P, CPMA, CRC
    Vice President, Columbus, OH AAPC

    One can never consent to creep when one feels an impulse to soar. ~ Helen Keller

  5. Default
    We have to also make sure a referring doctor is listed on the claim along with the CLIA # and the QW modifier

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